New Aspects of Melasma/Novi aspekti melazme

Abstract

Etiology and pathogenesisEtiopathogenesis of melasma is multifactorial and remains unclear. Genetic and hormonal factors and exposure to UV radiation are classical influencing factors. There are many other factors that may play a role in the etiology of melasma, such as ingredients in cosmetics, phototoxic and anti-seizure drugs, endocrine disorders (ie, ovarian or thyroid dysfunction), hepatic dysfunction, parasitoses, and nutritional deficiency. It is important to note that most cases of melasma in men and up to one third of cases in women are idiopathic (5).Ultraviolet exposure is a major triggering and aggravating factor in the development of melasma, since it has a well known ability to stimulate proliferation of melanocytes, their migration, and melanogenesis (1). However, UV-induced hyperpigmentation usually recovers spontaneously, whereas melasma does not. Recently, Kim et al. detected down-regulation of the AbstractMelasma is a common cosmetic problem and its severity ranges from minor pigmentation during pregnancy that resolves spontaneously, to a chronic, troublesome, disfiguring condition. Today, there are various treatment modalities for melasma, providing a different success rate. The need for an effective treatment for melasma is becoming more and more significant probably due to the current lifestyles with increased UV exposure, broad use of hormones for contraception and hormone replacement therapy, as well as increasing esthetic demands. The mainstay of treatment is regular use of sunscreens along with topical medications suppressing melanogenesis. This review summarizes recent progress in understanding the pathophysiology of melasma and implications for new treatment strategies.

Treatment Evaluation of Melasma Patients in Dr. Hasan Sadikin General Hospital Bandung in period of 2013–2014

“…The goal of melasma treatment is to inhibit the pigmentation process and remove or destruct the formed melanin. 3,7 The usage of topical drugs is to inhibit the enzymatic process in pigment production. 12 The combination of hydroquinone and tretinoin was often used in this treatment.…”

“…1,2 This condition was characterized by brown to gray-brown macula with irregular border. 1,3 Melasma more frequently occurs in women compared to men and in the dark-skinned people. 1,3 This disease can be found in the average age of 27.5±7.8 years old and rarely found in puberty.…”

“…1,3 Melasma more frequently occurs in women compared to men and in the dark-skinned people. 1,3 This disease can be found in the average age of 27.5±7.8 years old and rarely found in puberty. 4 This condition affects more than five million people in America and 7760 patients have been found in Ethiopia.…”

“…5 The treatment of melasma in each person is different and needs long term treatment. 3,8 Difficulties in treatment of melasma arise from high tendency for relapse, expensive cost and high risk of side effects such as erythema, sores, scales and acne eruption. 3,8 Standard therapy of melasma in Department of Dermatology and Venereology of Dr. Hasan Sadikin General Hospital Bandung according to guideline melisma is divided into two parts; i.e general and specific.…”

“…Treatment evaluation can be assessed by Melasma Area Severity Index (MASI). 3,5 This scoring is calculated by assessing three indicators, i.e area of involvement, darkness and hyperpigmentation homogeneity. 2 To calculate MASI score, the sum of severity grade for darkness and homogeneity is multiplied by numerical value areas (forehead, right malar, left malar, chin).…”